Organizations need to end the stigma that prevents sufferers from being noticed or seeking help. Here’s how to change that from the top down and the bottom up.

The tragic suicides this month of Kate Spade and Anthony Bourdain underscored how depression can go unnoticed even by those who are close to its sufferers, despite how widespread the condition really is. Researchers estimate that 1 in 4 adults will experience a mental-health issue over the course of their careers, and the World Economic Forum recently projected the global economic burden of mental illness over the two decades between 2011 and 2030 at $16.3 trillion.

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It’s staggering figures like these that lead Sara Evans-Lacko, associate professorial research fellow at the London School of Economics and an expert on depression in the workplace, to believe that employers need to better support employees who may be silently struggling with depression and similar issues. Here’s how.

Recognize the problem . . .

Organizations first need to acknowledge the scope of the problem. Indeed, they may be reinforcing discriminatory taboos without even realizing it, Evans-Lacko points out. “There are studies that show that when employers are asked to evaluate prospective employees, they give the lowest ratings to those with mental illness,” she says, “compared with prospective employees who may have physical illness or disabilities or no illness at all.”

Once hired, employees with mental illness may be treated dismissively. In many workplaces, it’s extraordinarily rare to find positive conversations like the one this tech worker sparked last summer, when she emailed to let her team know that she’d be taking off a couple days to focus on her mental health. Her CEO wrote back thanking her for helping “cut through the stigma so we can all bring our whole selves to work.”

While many companies offer resources for those struggling with mental illness, Evans-Lacko says work cultures don’t always encourage people to use them. “I was just talking to an investment banker who had experienced depression,” she recalls, “and he said his bank has a lot of services” that are badly underutilized. “There was a real sense that you have to be tough in that environment and not take time off,” she says he told her. “So there was a mixed message: There are services available for those with depression or mental health issues, but nobody is talking about that issue.”

Indeed, in forthcoming research Evans-Lacko has found that over 70% of people with mental illnesses conceal their challenges from coworkers and managers.

. . . And commit to fixing it

Top-down efforts can help shift things in a positive direction. For example, over 700 employers have signed onto the U.K.-based anti-stigma campaign Time to Change. Canada’s Mental Health Commission runs a program called Opening Minds to address the same goals. And in the U.S., the National Alliance on Mental Illness similarly runs a StigmaFree initiative to end discrimination.

Employers can sign onto campaigns like these in order to gather best practices and publicly declare their commitment to supporting mental health. But they also simply need to spend more on mental wellness, which can have real business upsides. U.S. Newsreported in 2015 that Aetna gained 62 minutes of additional productivity per employee per week after introducing 13,000 of its team members to a wellness program; participants’ stress levels dropped 28%, and sleep improved 20%.

Ask managers to take the lead

“The most enlightening finding in our research,” says Evans-Lacko, “is the importance of having active support from the line manager” instead of “just suggesting that the person take some time off work or see a health professional.” In other words, it’s about engaging with mental health inside the workplace, rather than outsourcing that task.

For example, “to help people with anxiety,” Evans-Lacko recommends “well-being programs and anti-stress days. They are really low cost. Workshops on mindfulness, meditation, or exercise sessions–in the form of walking groups or yoga sessions–help people deal with anxieties and pressures.” These can all be hosted right in the office during lunch breaks or after working hours.

“And for the more serious problems,” Evans-Lacko says, managers need to be trained on “how to deal with staff who become overwhelmed and get to the point where they have a real crisis.” When a direct report appears stressed out, she says, “it’s probably good to ask the employee about it. But don’t just have a conversation to say, ‘What’s wrong?’ Have the conversation to say, ‘I need to know what’s wrong so I can support you and you can do a better job here.'”

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Teach everyone to tune in (and reach out)

Evans-Lacko believes everyone has a role to play in identifying symptoms of depression and mental-health pressures, not just managers and senior leaders. “Those with depression might have lower energy, be anxious, ‘down,’ or feel hopeless about their work,” she explains, noting that these signs can be recognized by coworkers–especially when they persist or become pronounced.

Indeed, some depression sufferers may only share their difficulties with trusted colleagues. “People with depression might be talking about feeling lonely, feeling sad, or feeling left out,” Evans-Lacko says. “In extreme cases they might say, ‘I just don’t feel there’s any point anymore.’ There is research that shows if you notice someone using these words or expressing these feelings, it is helpful to reach out and say, ‘How are you feeling?’ ‘Are things okay with you?'”

Evans-Lacko adds that fears about broaching this subject are largely unfounded. “There is research that shows it doesn’t make people more likely to commit suicide by asking them these questions, though you have to be sensitive, and you don’t have to do it in front of everybody.”

If all the above pieces are in place, it should become easier for those struggling with depression or mental illness to come forward and seek out support. Speaking to the the Telegraph last year, former Unilever executive Geoff McDonald recalls having a frightening panic attack in 2008, which led to his doctor diagnosing him with anxiety-fueled depression. Thanks to some combination of personal courage and confidence that he’d be supported at work, McDonald says he determined that he “was not going to be burdened by the stigma that is linked to having depression and anxiety.” So he told everyone around him, including his employer. Happily, he says, “I got all the love and support I needed to get better–and I got better.”

If companies can’t signal, in both word and deed, that they can support those suffering from depression, then people like McDonald won’t feel comfortable asking for help. We already know the tragic consequences that can follow. It’s time to do better.

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About the author

Judith Humphrey is founder of The Humphrey Group, a premier leadership communications firm headquartered in Toronto. She also recently established EQUOS Corp., a company focused on delivering emotional intelligence training to the fitness, medical, and business sectors